Individual provider Active NPI

Kimlie Morrison Mitchell, MSW,LCSW

  • Clinical Social Worker
  • Raleigh, NC
National Provider Identifier
1710969605
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C002625 Issued in NC
Practice address
5561 McNeely Dr
Raleigh, NC 27612-7625
Phone
(919) 782-0272
Fax
(919) 782-0322
NPI assigned
Nov 16, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C002625 NC Primary

Addresses

Primary practice location

5561 McNeely Dr
Raleigh, NC 27612-7625

Mailing address

1932 Amity Hill CT
Raleigh, NC 27612-2869
Phone (919) 846-1647

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040727001212 NC Practitioner - Clinical Social Worker 4789654880 Practice locations: Raleigh, NC

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1932 Amity Hill CT
Raleigh, NC 27612-2869
Phone (919) 280-2116

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1132099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1710969605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1932 AMITY HILL CT",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276122869",
            "telephone_number": "919-846-1647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5561 MCNEELY DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276127625",
            "telephone_number": "919-782-0272",
            "fax_number": "919-782-0322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "KIMLIE",
        "middle_name": "MORRISON",
        "name_prefix": "Mrs.",
        "credential": "MSW,LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-16",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C002625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.